Avaliação da tromboelastometria (Rotem® Delta) em cavalos de turfe da raça puro sangue inglês com hemorragia pulmonar induzida pelo exercício
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Data
2018-02-27
Autores
Wilmsen, Maurício Orlando
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Universidade Estadual Paulista (Unesp)
Resumo
A hemorragia pulmonar induzida pelo exercício (HPIE) é uma das principais pneumopatias que acometem o trato respiratório de equinos atletas do turfe. Tendo em vista a média de participação desses animais em provas, e possivelmente o estabelecimento de lesões crônicas, as alterações de remodelamento em paredes brônquicas e parênquima pulmonar favorecem a fibrose e comprometem, através da ativação excessiva e persistente, o sistema hemostático. Este trabalho teve objetivo avaliar o perfil hemostático e os possíveis quadros de hipo ou hipercoagulabilidade em cavalos atletas do turfe com HPIE. Assim, foram selecionados 26 cavalos, da raça Puro Sangue Inglês em campanha no Joquey Club Brasileiro (JCB) do Rio de Janeiro, avaliados em dois momentos, pré e pós exercício extenuante e com e sem o uso de furosemida. Os animais com HIPE foram dividos em dois grupos, grupo controle (GC) e grupo furosemida (GF), os animais do GF receberam a medicação quatro horas antes do páreo (250mg/kg/IV). As amostras de sangue para realização da tromboelastometria (TEM), hemograma, análise bioquímica, lactato plásmatico, tempo de protrombina (TP), tempo de tromboplastina parcial ativada (TTPa) e concentração de fibrinogênio foram coletadas em dois momentos para ambos os grupos, pré e pós prova. As análises estatísticas foram realizadas de acordo com a distribuição das variáveis ao nível de 5% de significância. Todos os animais deste estudo apresentaram HPIE, diagnosticados através de endoscopia óptica flexível. Os resultados inerentes ao estudo demostraram um perfil de hipocoagulabilidade sanguinea após o páreo. As principais variações na TEM aconteceram nos três testes inTEM, exTEM e fibTEM, com alterações nas variáveis tempo de coagulação (CT), formação máxima do coágulo (MCF) e ângulo alfa (A°α) aumentados. O TTPa (p=0,04) foi maior no grupo controle no pré exercício enquanto TP e fibrinogênio (p<0,001) no pós exercício. O número de plaquetas pós corrida foi menor quando comparado ao pré exercício (p<0,001). A interpretação conjunta dos resultados permite concluir que cavalos com HPIE possuem uma predisposição ao risco hemorrágico devido ao quadro de hipocoagulação verificado através da TEM.
Exercise-induced pulmonary hemorrhage (EIPH) is one of the leading pneumopathies affecting the respiratory tract of turf equine athletes. Considering the average participation of these animals in tests, and possibly the establishment of chronic lesions, remodeling alterations in bronchial walls and pulmonary parenchyma favor fibrosis and compromise, through excessive and persistent activation, the balance of the hemostatic system. This study had the objective of evaluating the changes in the hemostatic profile and the possible hypo or hypercoagulability of horses in the turf with EIPH. Therefore, 26 Standerbread horses were selected at the Brazilian Joquey Club (JCB) in Rio de Janeiro, evaluated at two moments, pre and post strenuous exercise and with and without the use of furosemide. The animals with EIPH were divided into two groups, control group (CG) and furosemide group (GF), the animals of GF received the medication four hours before the pareo (250mg / kg / IV). Blood samples for thromboelastometry (TEM), blood count, biochemical analysis, plasma lactate, prothrombin time (PT), activated partial thromboplastin time (aPTT) and fibrinogen concentration (Fib) were collected at two times for both groups, pre and post test. The Statistical analyzes were performed according to the distribution of variables at the 5% level of significance. All the animals in this study presented HPIE, diagnosed through flexible optic endoscopy.The results inherent to the study demonstrated a profile of blood hypocoagulability after the pareo. The major alterations were observed in three inTEM, exTEM and fibTEM tests, with main alterations in the variable increased coagulation time (CT), maximum clot formation (MCF) and alfa angle (A°α). The aPTT (p = 0.04) was higher in the pre-exercise control group while PT and fibrinogen (p <0.001). The number of platelets post race was lower when compared to pre exercise (p<0,001). The interpretation of all the results allows to conclude that horses with EIPH have a predisposition to the hemorrhagic risk due to the hypocoagulation picture verified through TEM.
Exercise-induced pulmonary hemorrhage (EIPH) is one of the leading pneumopathies affecting the respiratory tract of turf equine athletes. Considering the average participation of these animals in tests, and possibly the establishment of chronic lesions, remodeling alterations in bronchial walls and pulmonary parenchyma favor fibrosis and compromise, through excessive and persistent activation, the balance of the hemostatic system. This study had the objective of evaluating the changes in the hemostatic profile and the possible hypo or hypercoagulability of horses in the turf with EIPH. Therefore, 26 Standerbread horses were selected at the Brazilian Joquey Club (JCB) in Rio de Janeiro, evaluated at two moments, pre and post strenuous exercise and with and without the use of furosemide. The animals with EIPH were divided into two groups, control group (CG) and furosemide group (GF), the animals of GF received the medication four hours before the pareo (250mg / kg / IV). Blood samples for thromboelastometry (TEM), blood count, biochemical analysis, plasma lactate, prothrombin time (PT), activated partial thromboplastin time (aPTT) and fibrinogen concentration (Fib) were collected at two times for both groups, pre and post test. The Statistical analyzes were performed according to the distribution of variables at the 5% level of significance. All the animals in this study presented HPIE, diagnosed through flexible optic endoscopy.The results inherent to the study demonstrated a profile of blood hypocoagulability after the pareo. The major alterations were observed in three inTEM, exTEM and fibTEM tests, with main alterations in the variable increased coagulation time (CT), maximum clot formation (MCF) and alfa angle (A°α). The aPTT (p = 0.04) was higher in the pre-exercise control group while PT and fibrinogen (p <0.001). The number of platelets post race was lower when compared to pre exercise (p<0,001). The interpretation of all the results allows to conclude that horses with EIPH have a predisposition to the hemorrhagic risk due to the hypocoagulation picture verified through TEM.
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Palavras-chave
Hipocoagulabilidade, Hiperfibrinólise, Hemostasia, Cavalo sangrador, Furosemida